Pomalidomide-Based Regimen Shows Improved Overall Response Rate and Progression-Free Survival for Patients With MM in First Relapse

The addition of pomalidomide to bortezomib and dexamethasone demonstrated a significantly improved progression-free survival (PFS) and overall response rate (ORR) among patients with first-relapsed multiple myeloma (MM), compared with control groups, according to study results published in Pakistan Journal of Medicinal Sciences. 

Previous research has shown pomalidomide to have stronger anti-myeloma activity than lenalidomide and when combined with bortezomib and dexamethasone demonstrated longer progression-free survival than bortezomib plus dexamethasone alone.

Researchers conducted a retrospective analysis to determine the efficacy and safety of pomalidomide plus bortezomib and dexamethasone as a treatment for MM in first relapse. Overall, 38 patients with relapsed MM were evaluated and 20 patients were treated with pomalidomide plus bortezomib and dexamethasone and 18 patients in a control group treated with bortezomib and dexamethasone alone. 

Patients treated with pomalidomide plus bortezomib and dexamethasone had a higher ORR than patients in the control group (85.0% vs 55.56%; P = .046). The median PFS was significantly longer in the pomalidomide group (9.118 months) than in the control group (4.75 months; P < 0.01). Independent risk factors for shorter PFS included the presence of extramedullary plasmacytoma, high-risk cytogenetic stratification, and elevated LDH levels (>240 U/L) at relapse (all P < 0.05).

Disease progression occurred in 17 patients in the pomalidomide group and all 18 patients in the control group. An overall survival analysis was not performed due to high censoring (> 70%) in both arms.

“Compared with bortezomib and dexamethasone, the combination of pomalidomide and bortezomib and dexamethasone regimen can significantly improve progression free survival and overall response rate in patients with primary recurrent multiple myeloma,” the researchers concluded.  

“Multiple myeloma is difficult to cure, and recurrence after treatment can affect patients’ survival time and increase their economic burden,” they added. “Pomalidomide provides a new treatment option for patients with recurrent multiple myeloma.”

Source:

Fan Q, Man Q, Wang Y. Effect of Pomalidomide-based regimen on the treatment of patients with first-relapsed multiple myeloma and analysis of prognostic factors. Pakistan Journal of Medical Sciences. Published online June 2025. doi:10.12669/pjms.41.6.10472